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General NPI Number Information
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NPI Number | 1164679510
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Entity Type | Individual
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Provider Name | VICTORIA LYNN TYRA RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | N61W23044 HARRYS WAY
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City | SUSSEX
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State | WI
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Zip | 53089-3995
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Country | US
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Telephone | 866-275-3737
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Fax | 414-566-7613
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Provider Business Mailing Address
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Address Line | 1301 DUBLIN ST
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City | GRAPEVINE
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State | TX
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Zip | 76051-2816
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Country | US
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Telephone | 972-977-9421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71009011B
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F349235-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 035877
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704438796
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024181497
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APNP9249
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0030325
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP117203
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95025997
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 64317
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License Number State | NM
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903244
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License Number State | MS
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